One year on Herceptin is best

Two recent studies presented to a European cancer conference have confirmed the current length of treatment with the anti-cancer drug Herceptin does the best job of staving off a recurrence of cancer.

Herceptin is a highly successful breast cancer drug, but has been surrounded by questions over how long it should be taken for, largely because it is expensive.

The studies will have a huge impact on Swiss-based Roche, which manufactures it, and currently sells the drug wholesale at a cost of about US$54,000 a year in the United States.

Globally, sales of Herceptin reached around US$5.6 billion in 2011.

If the studies, one of which was sponsored by the company itself, had concluded that shorter treatment periods were just as effective, then the company stood to lose around US$1 billion of those sales annually.

Herceptin is generally used following the removal of breast cancer tumours in patients in the early stages of the disease, to prevent a recurrence.

The Roche-sponsored study, which was presented this week at the annual meeting of the European Society for Medical Oncology in Vienna, sought to investigate whether two years of treatment with Herceptin would be more effective in preventing a recurrence of the cancer than one year.

However, researchers found no difference in survival times or rates of recurrence between patients taking Herceptin for one year, and those who took it for two years.

Meanwhile, a second study by France's National Cancer Institute set out to test whether taking Herceptin for just six months would have a similar effect on treatment outcomes as taking it for a whole year.

Insurance companies, government health programmes and patients could have saved large sums of money if a shorter treatment programme had turned out to be as effective as a year's worth of Herceptin, which can also give rise to side effects including heart problems.

However, the Institute found that the women who only received Herceptin for six months had a 28% higher risk of a recurrence of their tumours than did the women who took it for 12 months.

While the difference was not very great when statistical methods were taken into account, the study is unlikely to support a move from a year's worth of treatment to six months in healthcare policy recommendations.

However, French investigators said they would carry out further studies to test whether certain subsets of patients would be just as well served by shorter treatment times.

According to Xavier Pivot, an investigator in the trial and professor at the Université de Franche-Comté, the researchers would present results of their extended study in December.

Researchers in Britain and Italy are currently also carrying out studies into which groups could receive similar benefits on shorter treatment programmes with Herceptin.

In 2006, a Finnish study showed that just nine weeks of treatment with Herceptin reduced the risk of a recurrence of breast cancer, with results that appeared to yield the same benefits as a year's worth of treatment in larger studies.

However, the two recent studies have not repeated this result.

Herceptin is used in around a fifth of breast cancer cases where tumours produce large amounts of HER2, a protein that boosts tumour growth.